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This case demonstrates a 59 year old, active Asian male patient, who presented with subacute left lower extremity ischemia in the absence of other findings or associated history. A vigorous exercise session resulted in new-onset, unilateral claudication symptoms. After two weeks, the progression to numbness on the dorsum of his foot raised concern for the patient, thus prompting his decision to receive treatment. The patient was found to have thrombus in his left popliteal artery with minimal evidence of atherosclerosis and the only potential culprit was a right ventricular mass. The treatment was a popliteal embolectomy with near-complete symptom resolution. This case elucidates an otherwise obscure etiology for limb ischemia in that a right ventricular lesion manifested with embolization to the leg related to a possible valsalva-induced reflux across the tricuspid valve.
